Thursday, January 20, 2011

Medical Physiology Study Tips

This guest submission by Igor Irvin Bussel, a second year medical student, describes tips on how to study for medical physiology with the aim of acing that inevitable physiology test. 

There is no topic more fascinating in medicine than physiology. Fundamentally, it is the study of life. To be more specific it is the science of function based on integration of systems, communication of signals, and elegant homeostasis.

As a former T.A. for Medical Physiology, I want to help students appreciate and succeed in their course without stress. There is a unique best way to study for each course/professor. I aim to have you study less but in a better fashion because nobody wants to study endless hours and still not score as high as they hoped.

Medical Physiology is a unique course because it is not about memorizing facts but rather
building a mind-set and framework for thinking about the function of the human body. With that in mind, realize that you are not taking medical physiology to become a doctor-- you will learn that by doing. You are a medical student. There is no M.D. after your name... yet. Study for the exams and all else will fall into place.

Even though everyone inherently understands that they have to study for exams, they still
study to be a doctor. Let me repeat and clarify myself: You are studying for exams on medical
physiology. You are not studying medical physiology to become a doctor.

Get the difference?

Once this is clear, you can actually use your exams for what they are-- directions for how to do
well in your medical physiology course.If you just study medical physiology without looking at past exams, you will not do as well on the actual exams as you would like. The course is just too broad for you to base your studies of what you assume to be important. As long as you went to lectures or have even a remote idea of what material you covered, you should take a look at the past exams that are available. Record what topics are addressed most often in questions and hyper-focus your studies to those high-yield areas. You should review all of the material presented but be sure that you have a thorough understanding of the high-yield concepts.

Do not wait to take practice exams days prior because you are not as ready as you would like
to be. You will never be fully ready -- ever. Nor will you achieve perfection. You can however
strive to be excellent. The very act of taking the practice exams will better prepare you for the actual exams and will provide further direction regarding your weaknesses. During your study
sessions, you should be in a constant state of awareness that there are critical points you still have not learned.

When taking the practice or actual exam, always do the easy problems first. Additionally, on
multiple choice sections, your attention should be devoted to finding the wrong answers. Since
there is only 1 correct answer and 4 wrong answers, it is not only easier to eliminate wrong
choices but it also increases the probability of having to make a guess if necessary. While you
are eliminating wrong answers and picking the correct choice, it is crucial to briefly write out your rationale for each decision. This redundancy not only ensures you didn't misread but also primes memories that may be advantageously accessed for later questions. I stress proving wrong and right answers because answer choices on exams are repeated more often than entire questions. More importantly, questions are often changed while answer choices are not.

After any exam, a post-mortem type of analysis must take place. What went well? What went
wrong? Stupid mistakes? Lucky guesses? Constantly evaluate performance, analyze trends, and
implement improvements. Do not waste time engaging in debates on minutiae and rationalization battles. The reality is that most rationalizations are based on faulty assumptions and unless evidence can be provided, these communications are a complete waste of energy, air, and time.

On a final note, while all courses will promote various text books, I think the best sources, if you need them, are the following:

1. Ganong’s Review of Medical Physiology by William Ganong

2. BRS Physiology by Linda S. Costanzo

Igor Irvin Bussel is a second year medical student at Chicago Medical School. Share your passion by publishing your writing on Scrub Notes today!

Updated 2015-12-20

Tuesday, January 18, 2011

Residency Interview Tips, Part 5: The Follow Up

So, you made it to the residency interview. You fit in well at the dinner and impressed on the interviews. Now you're walking out the door, back to your car, or to the airport, and off to your next interview. You're finished with this program til you place it on your rank list, right? Wrong! Now is the time to really seal the deal. Think about it: you were just granted this wonderful opportunity to interview for an actual job in a down economy. Not everyone is so lucky, whether they are trying to find jobs in allied health or pursuing careers in other professions like business or trying to get into law school.

There are a lot of myths out there about how to communicate with the residency program after the interview, and frankly, a lot of times, the answer is: it depends. But, there are some things you should do regardless, and here they are:

Write Thank You Notes To Your Residency Interviewers
This seemingly no-brainer move tends to the bane of the medical student after the interview. Writing thank you notes is tedious, time-consuming, and does not offer any guarantee of advantage in ranking let alone any guarantee that your interview will receive your note! Still, while this is not sufficient to gain any advantage, you should view it as necessary to avoid being at any disadvantage. The steps are simple:

  • Make sure to get contact information from each interviewer at the interview
  • Use a basic template to speed things up for yourself
  • Add in something unique that came up from each interview to trigger a positive memory of you when read
  • Do not be too verbose - keep it short and sweet
  • Put your contact information beneath your signature in case the interviewer wants to be in touch
One 'modern' question about the ritual: should the thank you note be handwritten or emailed? 
The answer is not so simple. Handwritten notes show more of an effort and seem more personal; however, they are harder for the interviewer to respond to and more likely to go unanswered / unacknowledged. One strategy is to write a thank you note within 24 hours of your interview and immediately mail it off. Then, a week later, send a one line email stating that you hoped the interviewer received your note and that you look forward to further discussing your interest in their field in the future. 

Another issue: should I thank the program director if I did not interview with them? The program coordinator?
Again, no straightforward answer, but remember that ultimately the PD is likely the one selecting residents and would be your future boss, so can't hurt to make a favorable impression there. Similarly, the program coordinator can have a huge influence on ranking decisions. Sending one or both a one-line thank you email cannot be anything but beneficial. 

The Penny Black: World's First Postage Stamp

Between Interviews and Rank Lists
Some programs begin interviewing as early as October. However, rank lists are formed in February. How do you keep yourself at the top of the list over 4 months of interviews and committee meetings? Make sure to keep in touch with the PD and PC as the months progress. Keep a list of questions that come up about programs in general (things such as health care benefits or how time off is given for board exams tend to become more pressing as interviews progress) and email the qs to each program director about once a month. That way, you not only gain more specific information about each program but also keep yourself fresh on their minds as time passes.

Should I do a second look visit to a residency program?
Again, it depends. You should really do it for your own informational benefit. While some programs view such visits favorably, others are neutral, and still others view them as intrusions into the workday of active residents. You also risk reversing the favorable impression generated on interview day. Lastly, there is the cost of visiting a program a second time. One approach is to inquire discreetly with the program coordinator about the feasibility of such a visit as well as ask around to see how such visits are viewed within the program of interest. 

Sunday, January 16, 2011

Residency Interview Tips, Part 4: The Interview

Okay, the big moment has arrived: the interview. You're on! But, don't worry - this isn't Larry King and this isn't nationally televised. You should view the interview as a chance to burnish your credentials for a residency program as well as gather more information about the program itself. The interview has four main components: the first impression & introductions, interview's questions, your questions, and conclusion. We break down the interview by each part:

The Residency Interview First Impression
While many interviews run late, make sure to be early to yours. Ask the program coordinator for detailed instructions on how to find the location if it is distant from the program office. Confirm the time and location. Ask people along the way if you feel unsure. There's no worse first impression than being late.

Since you should already be wearing standard interview clothes, that shouldn't be an issue. When you enter, smile - the interview should be fun for both you *and* the interviewer! Shake the interviewer's hand firmly while saying your name slowly and clearly. Take your seat promptly and place your items next to or below you. Sit up straight but don't lean forward too much. Make sure both feet are on the ground and your arms are relaxed by your side. Basically, your posture should convey quiet confidence. And keep smiling!

Hopefully, your interviewer is mirroring your actions. As you start in on the pleasantries, take a moment to note the office. Sometimes, you can introduce mementos on the wall in order to broaden the discussion as well as show that you are perceptive. However, be careful in this regard as sometimes interviews are conducted in borrowed offices. There are many other similar interview tricks you can employ in order to relate to your interviewer.

The Interviewer's Questions
After the introductions are complete, you can expect a short blurb from the interviewer about who they are and perhaps a bit about the program. Eventually, they will segue into the actual interview questions. Typical questions are covered in many places, and mildly vary by specialty. The key here is to be clear and straightforward in your answers. You should not spend more than 2 minutes answering any particular question. Avoid rambling. Stick to your points. Don't worry if you take a momentary pause to answer a question - it shows that you are actually thinking about your response versus just spitting out whatever comes to mind or whatever you have memorized. As interviews progress,  you will find that most questions revolve around "Tell us about yourself," "Why did you pick this specialty?" and "What do you find attractive about our program?" so be prepared to handle those adeptly.

Your Residency Program Interview Questions
After about 10-15 minutes, most interviewers will wrap up their questioning and ask you if you have any questions. You HAVE to ask something here, even if you have no real interest or question. Obviously, if you are curious about something the interviewer said during their portion, ask about that. Otherwise, you can go in one of two directions. First, ask questions about the structure of the program, whether it be rotations or what the interviewer views as strengths / areas that need improvement for the program. It is also helpful to ask about the future, with regards to fellowships or career prospects, or just where they feel the field is headed in general. The other line of questioning is to ask about factors outside work, such as how it is living in that city or neighborhood, or how the culture of the program is. This line of questioning is bigger risk / bigger reward. Some interviewers will view this as showing you lack seriousness, but for others, this is a good way to forging a bond that lasts beyond the interview. Judge how the interview has gone thus far before deciding to engage in this line of peripheral questioning.

Residency Interview Conclusion
Take about 5-10 minutes to ask your questions. Don't pepper / aggressively question the interviewer. If you have tough questions about say, accreditation or board pass rates, save those for the program coordinator or program director. Not every interviewer is up to speed about every aspect of the residency program. As the questions wrap up, try to leave the same way you came in, exuding a quiet confidence. Smile and shake hands firmly. Make sure to ask for a business card or note down contact information in order to send correspondence once you are done with the interview. You can frame it as wanting a way to communicate in case you have further questions. Some programs are more upfront about providing contact information, but you have to solicit it yourself in many places. Walk out the door with your head held high and move on to your interview.

By the end of the day, and certainly after several interviews, you will be a pro. Congratulations! You're basically done with all the heavy lifting of attaining a position as a resident physician!

Friday, January 14, 2011

Residency Interview Tips, Part 3: The Interview Day

After you have carefully scheduled your medical residency interview and done the requisite preparation, the interview day has finally arrived! Although, for most applicants and most programs, the interview day really begins on the interview day eve with some kind of meetup, which may range from very casual happy hour to a full formal dinner. The main components of the interview day consist of: getting to the dinner, putting your best foot forward at the dinner, getting to the interview, and the residency program / interview day overview.

Getting To The Residency Program Interview Dinner

As stated above, this "dinner" could really be a very laid-back happy hour, or it could be fine dining at a four star restaurant. Regardless, to partake, you have to get there first! We are presuming here that you have already used Kayak or Orbitz to find a flight to your residency program interview. Once you have checked into your hotel though, your main priority should be local transportation to the dinner. Ideally, you would have looked into this beforehand, but if you have not, here are some options to consider:

  • Take a taxi - the quickest most reliable way in most cities to get to where you are going, but often the most expensive, especially the further West you go, where cabs are less commonly used
  • Use local transportation - again, better on the East Coast. You may not have much of an issue getting there, but sometimes the dinner may run long and getting back would be a hassle or even unsafe in certain cities in the Midwest, South and West.
  • Find a friend - if the hotel is commonly used by interviewees, you may be able to share transportation with them to save money as well as have a more enjoyable ride over. Plus, two minds are better than one when it comes to navigation
  • Navigate - if you have rented a car, it may come equipped with a GPS system in which case you can simply punch in the address and drive. If the GPS is optional, I would highly recommend taking it. Better yet, simply buy your own GPS machine and bring it with you! You can use the GPS in your own car once the interview is over. Personally, I found the Garmin Nuvi systems to be quite good. Make sure to get voice navigation too.
  • Ask the program - sometimes, the program coordinator can arrange for one of the hosting residents to give you a ride to and from your overnight location.

Looking Your Best At Your Residency Program Interview Dinner

A lot of the advice for the interview dinner is the typical interview advice one sees dispensed in general. However, despite the ubiquity of such advice, medical student interviewees are at a relative disadvantage. We do not generally interview as much as people going into traditional jobs nor do we receive specific advice as part of our formal medical curriculum (although many schools do offer mock interviews and the like). Keep in mind the following points:
  • Dress For Success - Even if the interview is "casual" such as a happy hour, dress nice. Do not show up in something you would wear at the beach or to a house party. Although the phrase is used in many ways, this really is an occasion where at a minimum you should dress "business casual."
  • Act The Part - You are an interviewee. Even if the residents are behaving casually or speaking without minding their p's and q's does not mean you should follow suit. Do not be lulled into a false sense of comfort - order food & drink tactfully, avoid alcohol, use proper language. Don't eat or drink so much that people think you need to have lap band surgery for weight loss or join alcoholics anonymous. Some residents may seem like your friend, but they may actually be taking notes on your behavior during the dinner which can make up part of your evaluation during the interview. Don't let a lax moment at dinner jeopardize your future job chances.
  • Be Forgetably Memorable - While paradoxical sounding, the point of this tip is that you want to make a good impression such that everyone has a generally nice impression of you without forming any specific memory. Avoid divisive topics like politics or religion. Even if you argue eloquently or are right about something, nobody cares. The residents want to know that you are someone they can work with. Conversely, you are there to learn about the culture of the program not win debates
  • Gather Information -  the dinner is a good time to ask about interview day specifics, such as who the likely interviewers are and what types of questions they may ask. Most residents are more than happy to volunteer such information. 

Transportation To Your Residency Interview

This is even more important than getting to the dinner. Make sure you have a reliable method for getting to the interview, which is often located miles away from the dinner site and possibly even in the opposite direction. If you have a rental car, do a dry run the night before if you have time to make sure you avoid any unexpected construction or road closures. Be aware that traffic patterns may be vastly different in the morning. If cabbing it, call ahead to schedule a pickup time. I'd suggest planning on getting to your interview 30 minutes before the scheduled start to give yourself a healthy cushion. There's nothing like being late to make a bad first impression.

The Residency Interview Orientation

Most interview days begin with a light breakfast and an orientation. You should be relaxed but also be aware that you are "on stage" already. Treat everyone from the program coordinator's assistant to the program director with the utmost respect. At some programs, the non-interviewing staff have a voice in the selection process. About a 1/3 of the programs I interviewed with had the program coordinator actually conduct one of the interviews. As for the other interviewees, keep the conversation light and avoid talking about the interview itself. You don't want to the person badmouthing another program director right when the PD walks in - you never know, but they may have been med school classmates or co-residents back in the day. Assume that everyone at the site will hear every word you say during the day. A healthy dose of paranoia never hurt =P That being said, this piece is meant to remind you to be smart during your interview. Be relaxed and confident and you should have no problems acing your interview!

Wednesday, January 12, 2011

Residency Interview Tips, Part 2: Preparation

The thrill of receiving a medical residency interview invitation is quite a rush. It represents the culmination of 4 years of hard work and study. However, between scheduling the residency interview and actually talking to your interviewer, you still have some work to do! Yes, just like most of medicine, the work never ends, but the work isn't too bad here and the payoffs make it more than worthwhile. Remember, like any interview, whether it is for an ultrasound technician position or for a bariatric surgery assistant to a medical residency position, the key to success is to make the best impression possible.

U.S. Army Medical Badge, 1902

Many resources are available to read about in general how to prepare for an interview. For residency programs, books like Iserson's Getting Into a Residency: A Guide for Medical Students or First Aid for the Match are helpful. I found Iserson's particularly helpful as he walks through many scenarios you may encounter, in particular questions that are 'off limits' per the Match NRMP rules and what to do when faced with one. However, do note that the book was written a few years back and some of the information may be a bit dated (for example, you do not really need to bring extra photos of yourself to the interview).

How To Prepare For Your Residency Interview
The first step is to gather background information about your program. Possible sources of information include classmates who have interview there, friends already at the program or from prior years that may have interview there, and mentors/advisors in the field. You can also consult bulletin boards online where many applicants routinely post about their experiences (like, for radiology, or for neurosurgery). Lastly, consider the programs themselves. They are great resources about technical details such as the structure of rotations or board pass rates. However, take non-objective information they provide with a grain of salt because they have an obvious strong bias to present themselves in a favorable light.

After learning about the program in general, try to find out more about your interviewers. You may politely inquire with the program coordinator, but not all programs release interviewer names ahead of time. If you find out their names, try doing a search on the program site to find out more about their areas of interest. Also look them up on PubMed to find out what their research interests are. Focusing on areas of common interest can help you stand out during the interview season. Another good resource is looking up the interviewer's CV - you may find out that you share a love for comedic movies or archery or ultrasonography!

Lastly, ask around! Word-of-mouth about interviewers and interview days can be the best gauge of what to expect not only from the day but from the program as a whole. Be especially mindful of programs where the program director is about to leave or has just changed. The PD can significantly affect the culture and structure of a program so try to find out more about the new PD's philosophy on resident education.

Ultimately, knowledge is power, so the more you know about the program, the more confident you can be going into your interview. And remember, just like Obama's grandfather told him, the key to success in life is confidence! So be confident and prepare well for your residency interview!

Monday, January 10, 2011

Residency Interview Tips, Part 1: Scheduling

January is the big month in the medical residency interview season. While the timeline of interview does vary by specialty, for most of them, January is the last month to schedule a residency interview! Some of you might be nervous and want to hold onto your favorite stuffed giant microbe, but never fear - a few simple tips will help you ace those remaining interviews.

"The Doctor" by Luke Fildes

Medical Residency Interview Scheduling

Unlike the interview depicted above, interviewing a prospective resident is quite a different prospect from interviewing an ailing patient. In fact, the interview begins even before you arrive on campus. It starts right when you receive the invitation to interview. After receiving the invitation to interview, enjoy the moment but do not celebrate prematurely: you still have to find an appropriate time to interview!

There are three main factors to consider when scheduling an interview: what interview dates are offered, when you have time to interview, and will you have time to travel to and from the interview site. In other words, residency interview slots x ( your schedule + travel time ) = residency interview! While this may seem overly simplistic, it becomes quickly complicated in practice when you are juggling 5, 10, or even up to 25 interviews (hello FMG/IMGs)! The key here is to be organized. Use a PDA or phone that allows you to email from almost anywhere so you can quickly respond to invitations or jump on spots that open up when others cancel.

Yes, quickly responding matters. There are a limited number of residency interview slots per residency program. Think about it: the program usually sends out a batch of invitation at the same time. Invitees will all be responding at the same time, so whoever responds first will get their choice of spots. Whoever responds last will be forced to go whenever a spot is available, or may even be put on a waiting list! So, when you get the interview dates, look carefully at when exactly interviews will be available.

Next, consider your residency interview schedule. If you already have interviews lined up, strike out those dates from the list sent to you by the program. See what dates remaining overlap. It is best to use an advanced calendar tool like Outlook or Google Calendar to keep all the dates straight. Of the dates that match, try to consider the region in which your other interviews are such that you can lump interviews in the same area together. Rank up to five dates that may work for the interview, but hold on before you send.

Don't forget to budget time for travel to your residency interview! It may take up to a full day to travel to and from a residency interview. Factor this in before you make a final determination. Once you do, rank up to 5 dates that could work for a residency interview and then respond to the program coordinator. If you are near the peak of the interview season and cannot find any free dates, do not be afraid to call the residency program coordinator. Oftentimes if you cannot find a suitable interview time, they may be able to schedule an interview with the program director one-on-one, or squeeze you onto a day that appears unavailable.

If you don't get the spot you want,  don't fret: as the interview season progresses, many interviewees begin to experience interview fatigue and start to cancel interviews. Stay in touch with the program coordinator about your favored days and more likely than not, something better will open up.

As you travel, make sure to stay comfortable. A travel pillow can make a huge difference in preventing neck and back strains on interview day as well as help you get some sleep as you cross time zones! Everyone knows you can take caffeine to stay up, but if you want a gentle way to readjust your circadian rhythms after you return from a trip, consider melatonin pills. Melatonin is a natural substance that helps regulate your body's sleep-wake cycle. Travel and jetlag can affect that equilibrium; it is better to use the natural substance to readjust the balance instead of a pharmaceutical like Ambien. Similarly, make sure you dress well, especially for those January interviews in places like Chicago and Boston! And double especially for medical students from warmer places in the South and West. Consider purchasing a scarf, leather gloves, and a pea coat to look professional while you try to stay warm! The added comfort these accessories provide will be more than worth the cost of purchasing them. Lastly, make sure your luggage and other items are both professional and functional. A roller bag for travel and leather portfolio are essential to meet both ideals. The portfolio is especially helpful in managing all the papers and information you will pick up over the course of your many interviews.

Remember, residency programs invited you which means they want you to come! After scheduling the interview, you will need to focus on interview preparation, but for at least the afternoon, enjoy the accomplishment! Congratulations!

Thursday, January 06, 2011

How To Become An Anesthesiologist

As fourth years wrap up interviews and third years begin to ponder the process, we will try to present posts regarding the career path for each specialty. Today, Scrub Notes contributor JCL, a fourth year medical student currently applying for residency programs, writes about how to become an anesthesiologist

Anesthesiology is a very demanding specialty which requires the mastery of a wide array of knowledge--from physiology, pharmacology, anatomy, to internal medicine and surgery. Anesthesiology not only challenges the cerebral arena but also requires manual dexterity and finesse. The best anesthesiologists are those who are very observant, fully utilizing one’s sensory and perceptive skills to make vital decisions that directly impact the outcome of a patient. They are also most often the calmest person in a room when something chaotic is occurring; they keep their heads when others are losing theirs. The anesthesiology profession calls on an intense but relatively short doctor-patient relationship. Do you trust a person to be your personal advocate to keep you alive during an operation which can potentially cause you death? An anesthesiologist must be calm under pressure, intelligent and decisive, as well as a team player to fully assure the best outcome for a patient, whether the patient is in the operating room or in the intensive care unit. The field of anesthesiology is a rewarding one in that one can choose from subspecialties within the area such as cardiothoracic, obstetrics, pediatrics, critical care, etc. The anesthesiologist is THE peri-operative physician. These “caped avengers” are also called upon to secure the airway in a code blue scenario or consulted on treating various acute cardiopulmonary diseases in the ICU.

One can become an anesthesiologist after going to medical school. Before doing so, one must decide if they want to become a licensed physician. Remember, nursing tracks to become a CRNA (a nurse anesthetist) are also available. CRNAs usually have some experience in ICU nursing care. CRNAs are usually supervised by MD-anesthesiologists in everyday practice and function as a part of the anesthesiology team.

To become a MD in the US, one must complete primary school, secondary school as well as college. One must take the MCAT to apply to medical school. The most important aspects of a medical school application are the applicant’s GPA and MCAT exam scores. Other things that would be extremely beneficial for a medschool application would be volunteering in the healthcare areas, research, as well as other interesting endeavors.

During medical school, it is important to decide whether a career in anesthesiology is for you. Those who seek the limelight or center of attention might not do well as anesthesiologists. Anesthesiology is considered successful when something DOESN'T happen. In the public eye, the anesthesiologist disappears from recognition. The happy anesthesiologist often recognize that the reward is the well-being of the patient at the end of the day, and that the patient made it safely through surgery.

If anesthesiology is for you, the anesthesia residency program is a total of four years of training after obtaining the Doctor of Medicine degree. To successfully match into an anesthesiology residency, the academic achievements are the most important aspects of the application (i.e. GPA, USMLE Step 1 and Step 2 scores). The anesthesiology residency has been getting more competitive in recent years.

Prep for the USMLE with Kaplan Medical! Enroll Today

The anesthesiology residency is made up of an intern year and three clinical anesthesia years. The first year is an intern year, which can be one of several options, such as a preliminary internal medicine year, a preliminary general surgery year, a transitional year which is made up of various areas, or some other internship year (peds, etc). The transitional year is usually a combination of medicine, surgery, ER, peds, and sometimes Ob-Gyn and elective time. Most anesthesia residents complete a prelim medicine year or a transitional year. Anesthesia residencies are either “categorical” or “advanced.” Categorical residencies are those which includes internship year in the program so the applicant does not have to apply to different programs. The advanced programs require the intern year to be completed before matriculating into a program. The average anesthesiology applicant applies to both categorical as well as advanced to maximize matching outcomes.

After anesthesiology residency, one can either go into private practice, academics, or pursue a fellowship (i.e. subspecializing). The current ACGME accredited fellowships are pain, cardiothoracic, pediatrics, and intensive care. To be “boarded” by the American Board of Anesthesiology, one must take written boards as well as oral boards. Nationally speaking, written board pass rates are about 85-88% and the oral pass rate 75%. After obtaining board certification, you have become an anesthesiologist!

Share your passion by publishing your writing on Scrub Notes today!

Updated 2015-12-20

Monday, January 03, 2011

Managing Medical Residency Interview Expenses

Many students are in the last push of interviews before Match Day. While we have posted before on general tips for residency interview travel, the following guest post goes into more specific details:

The time has come for you to interview, and congratulations are in order. The hardest 3 years of medical school are behind you. But you will hemorrhage money during the next few months if you are not adequately prepared. In order to prepare well and travel efficiently, consider each dimension of your travel (airfare, hotels, car rentals / transportation). Let's start with the most expensive piece: airfare.


This is where most of your travel dollars will be spent. The more competitive the specialty you’re applying to, the more locations you’ll want to visit, and the harder it will be to coordinate them by region. If possible, try to cluster a few interviews in one corner of the country at once. This will save you the time, money and energy required to fly from say, California to Virginia. Kayak has a helpful feature that lets you plan multi-point (or non-round-trip) flights to facilitate such trips.

However, be aware that the more competitive specialties with small program sizes offer fewer residency interview days, and such a cross-country journey might be unavoidable. You also may have to visit the same city twice. For example, Tulane ophthalmology’s only interview days were November 5 and 12, and LSU’s only days were December 2, 3 and 4.

When to book: The first batch of interview invitations is usually sent a month before the earliest available interview days. If you have two interviews several days apart in one part of the country, you can avoid flying back and forth by calling / emailing program coordinators to see if they have room to add you to their interview schedule. Start calling the program coordinators as soon as you receive the invitations, but it is okay to wait before finally picking a date. I waited 2-3 weeks before the date I picked, waiting for other invitations to come through, so that I could schedule something else nearby r and avoid paying for multiple round trips. Between a New York ophtho interview and a Yale ophtho interview that were a week apart, I was able to add on a New Haven transitional year interview and a D.C. preliminary medicine (round trip AMTRAK) interview during the gap. Just be careful... spots can go fast!

Who to bookKayak will compare fares among the major airlines that are its affiliates. However, it is important to consider several budget airlines that do not participate. Southwest is easy to book online and pretty cheap, but like all airlines, expensive to reschedule. Similarly, check out JetBlue especially for interviews in the Eastern part of the country.

If you get a last minute interview invitation, Priceline and Travelocity can get you a better deal, but be specific about your arrival and departure times. I wouldn’t use these to schedule an interview far in advance because your interview schedule may change. When a large city has multiple airports, it’s also helpful to consider which airlines fly to the airport that will be closer to your interview.


Hotels are very pricey in places like NY and DC. I tried to stay with friends whenever possible, and Facebook was very helpful for finding college friends who had moved to various cities. Just click the “Find Friends” tab in the upper left to reveal the drop down menu, then “See All Friends,” then find “Search By Current City” in the white drop down menu.

If you cannot find a friend to stay with, consider using sites like Priceline, HotwireKayak or Ideally, pick one site and use it all the time. For example, on, if you book 10 nights (3 nights here, 2 there, 5 somewhere else), you get an 11th night free in *any* hotel, subject to availability. There are other seasonal deals available, such as:  Orbitz Winter Hotel Sale: Save up to 50%! The offer is running until January 23, 2011.


If you can’t get rides from friends or book hotels within walking distance of the interview, Hotwire (specifically Hotwire Hot-Rates) and Priceline are the cheapest for renting cars, and this can be done in short notice. Many cities and hotels have airport shuttles that are cheaper than cabs, but these might take too long if you have an early flight for an interview the very next day. Check a city’s Metropolitan Transit Authority website or even Google Maps to see if you can plan a route by subway. Program coordinators have helped interviewers with these kinds of issues every year, and they are a helpful resource for answering questions regarding what’s practical. The main point of this section is to avoid using a cab. Try your best to get a deal, but remember: at the end of the day, the goal is a successful interview, no matter the cost!



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